Bi-Lateral TKR's anyone?

[bottomshollow]

Roxie, your knees will be fine after surgery---they're metal and plastic and feel no pain---but the bones, the muscles, tendons, ligaments, and soft tissue will be very, very sore. But with proper pain management you will be minimumly uncomfortable. Getting up and getting down will be a challenge in the beginning---once up you'll feel fine, once down you'll be okay. I personally didn't want going to the bathroom (except for the walking to get there) to be a form of exercise---I just wanted to be relieved. You need something with arms that you can put your hands on to push up from the toilet as well as from the chair or sofa you select to spend most of your time in. The less distance you have to stand up or sit down the more comfortable it will be---you'll have plenty of time after the first month or so to make getting up and down an exercise.

I already had a lift recliner that I bought when hubby had to get a new one. I lived in it with my hip replacement and then when I had both knees replaced. If I had had a regular recliner, I would have had my
son or grandson put it up on four by fours to lift it up more for me. I am short so my bed was not a problem; it was a good height for getting in and out of---and I didn't spend too much time there for the first 2 months.

You will be more mobile than you're thinking you will be at the moment. However, I always encourage bilats to go to inpatient rehab for at least a week. You need that time for healing and for thinking of no one but yourself. And you'll have a lot of help that you may need that first week. Then you'll be in good shape for going home---where we all do more than we should.

If we can be of more assistance or if you have more questions, let us know. We care.

 

[referee54]

Judy - You have been a wealth of information more than I can say for my OS office staff at this point... all I got from them is show up to the hospital on this date at this time and they will tell you everything... doesn't give me much to prepare for, thank goodness for this site! I have 2 insurances.. so hopefully what one won't cover the other will...
I have read conflicting info on the use of a toilet seat riser, some are saying it is good therapy but to get the stands that go around it to help support you when sitting and standing back up...
Can I ask if you or anyone knows how far your knees will typically bend to allow you to sit down once you are released to go home? Having both done at same time I am concerned that I will be stiff legged and not able to sit down or get up without help or a chair lift???
Darn I was hoping for a shorter time to enter the pool, our swimming window is usually up to the beginning of October for warmer water.. my 6weeks will be the end of Sept.. not sure I would be able to get up into the spa, but I could walk circles in there and it's always 102 - 104!
I will see if the hospital can give me more info, hopefully they have an information line that can give this info out.. otherwise I am at the mercy or my insurance and OS office getting it all together..
Thanks so much again Judy!

My knees were not quite at 90* when they sent me home, but I did make slow but sure progress. You will walk a little stiffly at first, as there will be swelling and stiffness, but the surgical pain and discomfort subsides and you will gain more and more ROM---sometimes slowly, but you will gain it--- You will be given PT and OT help and advice while at the hosptial, so you will learn how to use the walker or the crutches; you will not be bed-ridden and you will be able to slowly and gently get around when you need to.

 

[AZRoxie]

Roxie, your knees will be fine after surgery---they're metal and plastic and feel no pain---but the bones, the muscles, tendons, ligaments, and soft tissue will be very, very sore. But with proper pain management you will be minimumly uncomfortable. Getting up and getting down will be a challenge in the beginning---once up you'll feel fine, once down you'll be okay. I personally didn't want going to the bathroom (except for the walking to get there) to be a form of exercise---I just wanted to be relieved. You need something with arms that you can put your hands on to push up from the toilet as well as from the chair or sofa you select to spend most of your time in. The less distance you have to stand up or sit down the more comfortable it will be---you'll have plenty of time after the first month or so to make getting up and down an exercise.

I already had a lift recliner that I bought when hubby had to get a new one. I lived in it with my hip replacement and then when I had both knees replaced. If I had had a regular recliner, I would have had my
son or grandson put it up on four by fours to lift it up more for me. I am short so my bed was not a problem; it was a good height for getting in and out of---and I didn't spend too much time there for the first 2 months.

You will be more mobile than you're thinking you will be at the moment. However, I always encourage bilats to go to inpatient rehab for at least a week. You need that time for healing and for thinking of no one but yourself. And you'll have a lot of help that you may need that first week. Then you'll be in good shape for going home---where we all do more than we should.

If we can be of more assistance or if you have more questions, let us know. We care.

Wow.... excellent explanations!.. you just alleviated most of my anxiety surrounding being home alone and what my dependency level will be.. I am a stubborn patient and can see that what I need to be most independent will be arms or handlebar type devices to help lift myself up or down, Gotcha! Oh and of course the structured well timed pain management...

 

[Nanners]

AZRoxie can't remember who it was, but they said they bought all they needed from Walmart.com. I did that and was able to get a toilet riser and a shower chair for really cheap. Better than I saw anywhere else. I got a leg elevator and some gel pacs from somewhere else before I saw the walmart.com post. But I got good prices anyways, becuz there is alot to choose from on the net. I think I got the leg elevator from Amazon.com.

But so far I have gotten a leg elevator, 3 more gel pacs, a adjustable shower chair and a toilet riser. I think those are just the basics you need. I wish I could afford the cyro cuff ice machine, but I lost my job in January and funds are a bit tighter right now. The list Judy is getting for you should help more. Don't you hate how the insurance tells you, oh you won't know if that is available till after your surgery? Really helps the nerviousness huh!!

Good luck buddy!

 

[AZRoxie]

My knees were not quite at 90* when they sent me home, but I did make slow but sure progress. You will walk a little stiffly at first, as there will be swelling and stiffness, but the surgical pain and discomfort subsides and you will gain more and more ROM---sometimes slowly, but you will gain it--- You will be given PT and OT help and advice while at the hosptial, so you will learn how to use the walker or the crutches; you will not be bed-ridden and you will be able to slowly and gently get around when you need to.

Hey Tim - Just curious what is normal ROM? what are we striving to get too? Good to hear that I will not be bed ridden... what advice do you have to sleep comfortably and not disturb your partner who will be getting up for work each day, besides separate beds?? LOL

 

[referee54]

I am not sure is there actually is a "normal ROM" you get what you get---you get what your body can handle---mine is around 130-ish. It depends on your physiology, the size of your muscles, the flexibility of your muscles, what ROM you may have had before your TKR, etc.

What is important, though, is that you can do the things that you love---the activities that mean so much to you---without pain.

As for sleeping comfortably, i have to be honest---I slept in a recliner in the living room for two-three weeks after I came home. I was comfortable, and I didn't bother my wife!

 

[bottomshollow]

ROM, Roxie, which I'm sure you know is range of motion, consists of extension (leg straight) and flexion (leg bent). The normal range is 0 degrees (perfectly straight-back of knee touches flat surface) and 135 degrees of bend---however one can function quite well at 120 to 125. Max flexion is 150---not many of us have that and certainly don't need it under normal circumstances. Some people have negative extension--the knee straightens past 0 degrees (it bows backward)---but you would never work to have this.

You need to remember that ROM is just numbers and in the beginning of recovery they are not that important. There is not a "window of opportunity" for ROM. So if you are told you have to get to a certain flexion number in a certain amount of time----stick you tongue out at them---they don't know what they're talking about. ROM usually increases over time with proper exercises unless there are unforeseen problems like adhesions---which very few people develop. Scar tissue and adhesions are not the same thing. Scar tissue tends to be hard early but over time it softens on its own.

And its good to remember that as one of our members, Twinkletoes, says---normal is just a setting on your dryer.

 

[muds]

Hello all!
I am scheduled for bi-lateral TKR's August 29th... very nervous and apprehensive about the pain and recuperation it will require but also excited to get my active life back! Nothing is more frustrating then being dependent on others to lift you off the ground and assist you when you have walked too far! I am sure I am singing to the choir here..
I would love to here from others in my area and if anyone has experience with any local physical therapy places? Als

Hi there I had my TKR done 3 years ago after 8 differeny surgeries to finally discover what was wrong. All went very well, I suffered a huge amount of pain, which my doctor put down to me also being young 36 yrs old, it did take a lot of time to heal but after a while I was fine. I did a lot of physio and saw a biokinetikist twice a week and very glad I did. I dont think you ever get back to normal though, I still can run, kneel or bend my knees properly. I do excercise on a bike as much as possible but still battle. I am now however having extreme pain in my one knee where the knee cap should be, it is like a really aching throb and very dibilitating, I am really battling and now find that wearing a knee brace is helping so if anyone else out there is also battling with this, I would appreciate some feedback.

 

[thethom]

Hi Roxie;
Welcome from another BTKR survivor. I personally wouldn't have done this any other way, in hindsight. Biggest challenge for me was my surgery complications (overmedicated by Hospital and surgical staff, had to go 4 days with no pain meds until I was "cleaned out" and could resume adequate pain control). 4 days in hospital and 8 days in Acute Rehab. It's been 13 weeks since my procedure and I have been released by my OS as well as my PT group. Listen to the wisdom on this site and you will do well . Walking, working out, and following my balance exercises, healing up nicely but SLOWLY. Gather some patience as you will need it. I hope to post some before and after knee shots soon, truly amazing ( 8 and 12 degrees of valgus in my pre-op knees, now straight as an arrow and "old" style pain free ). ROM is "about" 120-125 , both knees and slowly improving.
Good luck and best wishes for your success......

Thom aka "Spiderman"

 

[AZRoxie]

Hi Roxie;
Welcome from another BTKR survivor. I personally wouldn't have done this any other way, in hindsight. Biggest challenge for me was my surgery complications (overmedicated by Hospital and surgical staff, had to go 4 days with no pain meds until I was "cleaned out" and could resume adequate pain control). 4 days in hospital and 8 days in Acute Rehab. It's been 13 weeks since my procedure and I have been released by my OS as well as my PT group. Listen to the wisdom on this site and you will do well . Walking, working out, and following my balance exercises, healing up nicely but SLOWLY. Gather some patience as you will need it. I hope to post some before and after knee shots soon, truly amazing ( 8 and 12 degrees of valgus in my pre-op knees, now straight as an arrow and "old" style pain free ). ROM is "about" 120-125 , both knees and slowly improving.
Good luck and best wishes for your success......

Thom aka "Spiderman"

Hello Tom! Thanks for the pep talk.. Wow over medicated during surgery?? Thats scary... so you just got released at 13weeks... does that entail as far as released to do what? Were you driving yet? This site has a wealth of wisdom and great suggestions... I am VERY thankful for everyone's input... I am now less than 2 weeks away, got a call from the hospital today to schedule my Pre Op testing next week and then from the insurance companies to go thru their questioning, made it that more real...

Thanks again and looking forward to see the postings from you as you progress!

Roxie

 

[AZRoxie]

Hi there I had my TKR done 3 years ago after 8 differeny surgeries to finally discover what was wrong. All went very well, I suffered a huge amount of pain, which my doctor put down to me also being young 36 yrs old, it did take a lot of time to heal but after a while I was fine. I did a lot of physio and saw a biokinetikist twice a week and very glad I did. I dont think you ever get back to normal though, I still can run, kneel or bend my knees properly. I do excercise on a bike as much as possible but still battle. I am now however having extreme pain in my one knee where the knee cap should be, it is like a really aching throb and very dibilitating, I am really battling and now find that wearing a knee brace is helping so if anyone else out there is also battling with this, I would appreciate some feedback.

Hey there Muds... sounds like the previous surgeries complicated things for you... I am sorry to read that you are in discomfort, I have high hopes that things will go smoothly for me and plan to tackle my rehab aggressively enough but not too much..
Nerves are setting in now with less than 2 weeks to go... we shall see...

Best to you!
Roxie

 

[AZRoxie]

So today is the reality day... Hospital called to schedule the Pre-Op Tests for next week, then Insurance companies called to verify all their info with me... less than 2 weeks to go, trying to get things set up at home, looking for one of those adjustable tables that I can roll in front of me and my recliner chair, that I might add I am still searching for the best one. I will be working from home hopefully after the 2nd or 3rd week, requires a couple of monitors to sit on that table and my laptop and keyboard... thats it!
Next on list is making a list of items to pack in my hospital bag..

 

[AZRoxie]

Roxie, here is the link for the Library info:
Tips for an easier recovery: Comprehensive List for hospital and home

Hey Judy - That link just took me to another conversation thread...

 

[thethom]

Hello Tom! Thanks for the pep talk.. Wow over medicated during surgery?? Thats scary... so you just got released at 13weeks... does that entail as far as released to do what? Were you driving yet? This site has a wealth of wisdom and great suggestions... I am VERY thankful for everyone's input... I am now less than 2 weeks away, got a call from the hospital today to schedule my Pre Op testing next week and then from the insurance companies to go thru their questioning, made it that more real...

Thanks again and looking forward to see the postings from you as you progress!

Roxie

Oh yeah ! I've been driving since week 5. Flying my small plane since week 8. Hardest part is in and out of seating but it's not that tough at all, just a bit uncomfortable the swing in and out of seating. By "releasing me" I just mean that the OS and PT don't need to see me any more unless any major mess up occurs.
Yes, the Operating Room anesthesiologist and floor nurses somehow pumped me too full of narcotics enough to stop respiration a few times. I have a very low tolerance to narcotics apparently. The cleaning out process took 4 days and after that smooth sailing, relatively. I was hitting 110 degrees of ROM and 0 degrees flexion by end of Acute rehab. Things will slow a bit after the first two weeks but they will improve as long as you keep up the PT and don't push to being inflammatory again and cause more swelling causing reduction of progress. All views you will hear on this forum.
Good luck. Will be watching for your recovery news.
Regards;
Thom

 

[Roy Gardiner]

I will be working from home hopefully after the 2nd or 3rd week, requires a couple of monitors to sit on that table and my laptop and keyboard...

Physically you may be able to do this because you won't have the vagaries of commuting, and having a laptop on the table is no more or less than having a book there. However you may find that mentally you're not up for it. Your body takes over after BTKR and devotes all possible resources to healing, leaving little for the brain to use.

You may be different, of course, but you may find that a couple of hours are all you can cope with.

 

[AZRoxie]

Physically you may be able to do this because you won't have the vagaries of commuting, and having a laptop on the table is no more or less than having a book there. However you may find that mentally you're not up for it. Your body takes over after BTKR and devotes all possible resources to healing, leaving little for the brain to use.

You may be different, of course, but you may find that a couple of hours are all you can cope with.

Roy - Thank you for that reminder, I realize I may need to have a "modified" schedule and work when I am alert.. nap a few hours... PT time... work a couple hours... nap... PT... work.. etc.. My first focus is the recovery and devoting as much energy as I have to my knees.
May be comical to see the ending results of me trying to work in the flowcharts I create or reports I review... :rolleyes:

 

[KayeKaye]

Physically you may be able to do this because you won't have the vagaries of commuting, and having a laptop on the table is no more or less than having a book there. However you may find that mentally you're not up for it. Your body takes over after BTKR and devotes all possible resources to healing, leaving little for the brain to use.

You may be different, of course, but you may find that a couple of hours are all you can cope with.

I found this to be so true when I had a foot surgery in 2005. I had planned on doing so much computer creative work, reading books and calling people. But truth was my brain just didn't cooperate, either did the pain meds. So I sat back and enjoyed it. That lasted about 12 weeks.

I wonder how long it will last for the BTKR?

 

[AZRoxie]

I found this to be so true when I had a foot surgery in 2005. I had planned on doing so much computer creative work, reading books and calling people. But truth was my brain just didn't cooperate, either did the pain meds. So I sat back and enjoyed it. That lasted about 12 weeks.

I wonder how long it will last for the BTKR?

I am wondering too Kaye... from what I can tell from the post op chats it could be 4-6 weeks before I feel somewhat functional and able to process things.. but will still need my occasional naps... could be an occupational hazard if I am on a conference call and suddenly start snoring! I have a very high tolerance of pain however I have a low tolerance for any narcotic, they knock me out very easily.. so we shall see...

 

[referee54]

Physically you may be able to do this because you won't have the vagaries of commuting, and having a laptop on the table is no more or less than having a book there. However you may find that mentally you're not up for it. Your body takes over after BTKR and devotes all possible resources to healing, leaving little for the brain to use.

You may be different, of course, but you may find that a couple of hours are all you can cope with.

I completely agree with this. The first three weeks after a BTKR are the "dark days." You most likely will be heavily medicated with narcotic pain meds, and I can tell you, that it was horribly difficult for me to concentrate on grading essays and writing assignments.

You will also be very tired for some time, as stated before---your body will be soaking up the energy due to healing, and the pain meds will also most likely cause some drowsiness and some not-so-clear thinking.

 

[AZRoxie]

So I have a odd question.. maybe not... is the length of the scar and the location usually about the same with all TKR's? Just curious if I can give a preference to my OS or if he would laugh me out of the prep room??
Guess my vanity is showing here...